Author(s)

Mai Nishimura, Ayaka Nakashima, Takuya Kushimoto, Mayako Goto, Susumu Yoshida, Osamu Sato, Kayoko Shikado, Kazuhide Ogita

Department of Obstetrics & Gynecology, Rinku General Medical Center, Osaka, Japan.

Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the gold standard diagnostic method at present. Recently, the spot urinary protein-to-creatinine ratio (P/C ratio) has been used to detect suspected preeclampsia, because it can be used to estimate the amount of 24-hour urinary protein. The aim of this study is to investigate whether an increase in P/C ratio precedes emergence of hypertension among inpatients with preeclampsia. Method: The P/C ratio in normotensive (systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) pregnant women was measured during regular prenatal checkups and in inpatients with preeclampsia between April 1, 2013 and March 31, 2014. Results: We included in this study 4074 normotensive pregnant women. The 95th percentile values for the trimester of pregnancy were 0.100, 0.157, and 0.195, respectively. The 95th percentile value for each trimester of pregnancy and gestational age were determined as criterion (Y) and predictive variables (X), respectively. In a simple regression analysis, the regression line was calculated as Y = 0.0035X + 0.0849 (R² = 0.9913). Twenty-one women were diagnosed with preeclampsia. In 14 patients with preeclampsia, the timing of the increase in P/C ratio to higher than the regression line preceded the emergence of hypertension. Six patients had no data on P/C ratio, and 1 patient had hypertension before the increase in P/C ratio. Conclusions: An increase in P/C ratio to higher than the 95th percentile value can be a useful predictor of preeclampsia.

Preeclampsia, Eclampsia, Protein-to-Creatinine Ratio, Pregnancy Induced Hypertension, Proteinuria

Nishimura, M. , Nakashima, A. , Kushimoto, T. , Goto, M. , Yoshida, S. , Sato, O. , Shikado, K. and Ogita, K. (2015) Increased Spot Urinary Protein-to-Creatinine Ratio Can Be a Useful Predictor of Preeclampsia. Open Journal of Obstetrics and Gynecology, 5, 808-812. doi: 10.4236/ojog.2015.514114.